Adverse Effect of Cyclosporin on Plasma Cholesterol in Renal Transplant Recipients

A prospective study of changes in plasma lipids after renaltransplantation was performed in order to compare the effectsof cyclosporin and conventional immunosuppression. Twenty-eightpatients were studied, 18 of whom were allocated randomly toimmunosuppression with either cyclosporin alone (nine subjects)or azathioprine and prednisolone (nine subjects). A furtherten patients received cyclosporin and prednisolone. Total cholesterol,triglycerides and HDL, LDL and VLDL cholesterol subfractionswere measured before transplantation, 21 and 90 days after transplantation,and also, in 12 patients (six on cyclosporin and prednisolone,and six on azathioprine and prednisolone), 2 years after transplantation. Triglycerides were initially elevated, and decreased after transplantationin all three groups. Total cholesterol was unchanged in theazathioprine and prednisolone group, whereas it increased significantlyby 90 days in both the cyclosporin group and the cyclosporinand prednisolone group. This was due primarily to LDL cholesterol,which increased by 45% in the cyclosporin group and 28% in thecyclosponn and prednisolone group. Both total and LDL cholesterolremained elevated 2 years after transplantation in patientsreceiving cyclosporin and prednisolone, but were unchanged inthe azathioprine and prednisolone group. There was no relationshipbetween renal function and plasma lipid changes.